Morton`s Neuroma - Floyd Memorial Hospital

WHAT CAN I EXPECT FROM TREATMENT?
Morton’s
Neuroma
With a proper diagnosis and a well-rounded
treatment plan based on effective orthotics,
the prognosis is excellent. Over 90 percent
of cases will respond favorably to proper
orthotic management if addressed early.
CUSTOM ORTHOTICS
With a physician’s order, our specialty
trained physical therapists can work with
you to create custom molded, perfect
fitting orthotics to assist with the pain and
prevention of further pressure on the nerve.
They can also address other deficits that
may contribute to Morton’s neuroma.
Floyd Memorial Physical Therapy
9407 County Road 403
Charlestown, IN 47111
(812) 256-0528
1615 Blackiston View Drive, Suite B
Clarksville, IN 47129
(812) 288-8817
2207 Concord Avenue NW, #100
Corydon, IN 47112
(812) 738-3616
724 Highlander Point Drive
Floyds Knobs, IN 47119
(812) 923-0630
1700 State Street
New Albany, IN 47150
(812) 948-7416
3891 Charlestown Road
(Behind Kohl’s)
New Albany, IN 47150
(812) 945-3440
WHO DO I CONTACT?
For more information about Morton’s
Neuroma or other conditions treated
by Floyd Memorial Rehabilitation
Services, call (812) 948-7416 or visit
FloydMemorial.com/Rehab.
FloydMemorial.com/Rehab
125013 (12/14) FMHHS
WHAT IS IT?
HOW DID I GET IT?
Morton’s neuroma is a common foot
problem consisting of a benign tumorlike enlargement of a nerve at the ball
of the foot. It is usually located between
the third and fourth toes, occasionally
between the second and third. This
condition is not a true tumor but rather a
thickening of the tissue around the nerve.
A neuroma is formed by irritation and
rubbing of the nerve, similar to the way
a callus is formed on your skin from
excessive rubbing or pressure. The nerve
“skin” gradually thickens to protect itself,
forming a benign tumor. This happens
when the arch of your foot collapses and
causes excess force to shift away from the
big toe and onto the smaller bones of the
front of your foot. These smaller bones
are not designed to handle such loads, so
the excess force tends to break down the
tissues under them, including the nerves
running between them to the toes. As the
nerve thickens to protect itself, it occupies
more space and is more easily rubbed.
Eventually, the nerve gets so big that it
is sensitive to every step and it can even
spread the toes (called “the daylight sign”
since you can see light between your toes).
WHAT ARE THE SIGNS AND SYMPTOMS?
Symptoms of a Morton’s neuroma include
sharp pain, burning sensation and even
a lack of feeling in the area. It is usually
worsened by walking and pressure on
the ball of the foot. This is a soft tissue
problem and will not show up on X-ray.
You may also notice that you can see an
increased gap or space between your
third and fourth toes. Moving your toes
in certain directions may also cause a
clicking sensation as the enlarged nerve
slides under a nearby ligament.
Shoewear that is too tight in the toe area,
high heels that place additional pressure
on your forefoot and an increase in activity
are also thought to increase the pain of a
Morton’s neuroma.
HOW IS IT TREATED?
As with most foot problems, there
are two main goals in the treatment
of a Morton’s neuroma:
1. Reduce the symptoms
2. Address the underlying cause
In order to obtain both goals, there
are several options and types
of treatment if rest, ice or antiinflammatory drugs are not effective.
Injections: Cortisone can be injected
into the area to control inflammation and
pain. This may be helpful in reducing the
pain temporarily but does not address
the cause of your symptoms. Overuse
of injected steroids can result in side
effects such as weight gain and increased
blood pressure and can interfere with
proper healing, which is why patients only
receive a limited number of injections.
Surgery: In cases that do not respond to
conservative measures, your doctor may
recommend surgery. Surgery is thought
to be very successful in reducing the pain
of a Morton’s neuroma but is a last resort
as it comes with risks. The procedure
involves the removal of both the tumor
and some of your nerve. This often causes
permanent numbness in the affected toes.
The nerve will grow back slowly over time.
If the underlying cause of the original
problem is not treated, the nerve will
become a “stump neuroma” which is often
more painful than Morton’s neuroma.
Foot Orthotics: The right custom
made orthotics will address your pain
by correcting the cause of your foot
dysfunction. This also restores proper
weight distribution over the big toe and
removes the abnormal pressures causing
your nerve to thicken. The nerve can then
heal and shrink back to normal size. It
is important to note that, as with most
conditions, attacking the problem early is
critical to avoid the need for surgery. Should
surgery eventually be necessary, using
foot orthotics immediately after can help
ensure that the tumor does not come back.